Provider Demographics
NPI:1134164767
Name:ROSARIO, ANDREA LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LEIGH
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 EL CAMINO AVE
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-5934
Mailing Address - Country:US
Mailing Address - Phone:916-993-3808
Mailing Address - Fax:
Practice Address - Street 1:2628 EL CAMINO AVE
Practice Address - Street 2:SUITE C-1
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5934
Practice Address - Country:US
Practice Address - Phone:916-993-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor